POS0821 CORONARY ARTERIAL INVOLVEMENT CAN BE OBSERVED IN A SIGNIFICANT SUBSET OF TAKAYASU’S ARTERITIS PATIENTS BY CORONARY CT-ANGIOGRAPHY
Authors: K. Abacar, A. Cincin, F. Baltacioglu, Z. Dogan, G. Sevik, H. Direskeneli, F. Alibaz-Oner
Journal: Annals of the Rheumatic Diseases (2022)

Background Besides the aorta and its main branches, coronary arterial involvement is also seen at a substantial rate in patients with Takayasu’s arteritis (TAK). Computerized tomography (CT)-angiography, as a non-invasive assessment tool, has started to be used instead of conventional angiography in the evaluation of coronary arteries. However limited data is available for its role in TAK patients. Objectives In this study, we aimed to assess the coronary arterial involvement by coronary CT-angiography in TAK patients with or without symptoms and to compare clinical characteristics of patients with or without coronary arterial involvement. Methods Patients with TAK (n=49, F/M: 40/9, mean age: 42.61±9.95 years) followed in Marmara University Vasculitis Clinic and underwent coronary CT-angiography with or without cardiac symptoms were evaluated retrospectively. Data of four patients who were not suitable for coronary CT-angiography but underwent conventional angiography were also included. CT angiography findings in the coronary arteries were defined as osteal stenosis, stenosis, calcific plaque and aneurysm and patients were categorized into two groups as those with or without coronary artery pathology. Demographic data, cardiac symptoms, clinical findings, BMIs, angiographic Hata and Goel classifications, treatments received for TAK, acute phase reactants and lipid levels were compared. Results Coronary artery pathology was detected in 14 patients (28.7%). Only 9 patients had a history of angina and 6 had cardiac symptoms in this group. Calcific plaque was present in 11 (22.5%), coronary artery stenosis in eight (16.3%) and aneurysm, osteal stenosis and occlusion in one patient each (2.0%). RCA was involved in 20.4%, LAD in 28.6%, LMCA in 22.4%, CX in 26.6% and more than one coronary arterial involvement in 26.5% of patients. In patients with coronary artery involvement, age (p=0.02), age at TAK diagnosis (p=0.004) and number of anti-hypertensive drugs (p=0.011) were significantly higher than those without coronary artery involvement. History of angina (p=0.004) and statin use (p=0.001) were also significantly higher in patients with coronary artery abnormalities, whereas HDL levels were significantly lower (p=0.037). No significant differences were observed between the groups when gender, smoking history, diabetes, BMI, ITAS2010 scores, biological therapy use, angiographic classifications, aortic involvement, presence of cardiac symptoms, CRP, ESR, total cholesterol and LDL levels were compared (Table 1). Table 1. Comparison of patient groups with and without coronary artery involvement (BMI: Body Mass Index, SD: Standard Deviation, ITAS: Indian Takayasu Activity Score, LDL: Low Density Lipoprotein, HDL: High Density Lipoprotein) Presence of Coronary Arterial Involvement (n=14) Absence of Coronary Arterial Involvement (n=35) p value Age 49.29 (8.23) 39.94 (9.39) p=0.02 Gender (F/M) 10/4 30/5 p=0.254 Disease duration, years 7.43 (6.42) 8.46 (6.25) p=0.608 Age at TAK diagnosis 41.21 (12.58) 31.37 (9.18) p=0.004 Diabetes mellitus 3/14 1/35 p=0.065 Family history 4/14 7/35 p=0.706 Smoking history 8/14 25/35 p=0.122 BMI (kg/m 2 ) 25.08 (2.53) 25.17 (4.68) p=0.930 Biological therapy 4/14 15/34 p=0.317 CRP (mg/L) mean (SD) 4.45 (3.4) 8.68 (24.08) p=0.642 ITAS2010 mean (SD) 0.57 (0.94) 0.51 (1.15) p=0.869 LDL (mg/dL) mean (SD) 102 (41.96) 112.44 (35.79) p=0.398 HDL (mg/dL) mean (SD) 46.23 (12.78) 55.12 (12.62) p=0.037 Cardiac Symptom 6/14 2/35 p=0.159 Aorta involvement 8/14 18/35 p=0.717 Statin use 10/14 6/34 p=0.001 Number of antihypertensives 1.79 (0.89) 0.85 (1.18) p=0.011 Acetylsalicylic acid use 10/14 24/34 p=1 Angina history 9/14 6/35 p=0.004 Conclusion Coronary artery involvement which is an important cause of morbidity and mortality can be detected non-invasively by coronary CT-angiography in up to 1/3 of patients with Takayasu’s arteritis, also in patients without angina and cardiac symptoms. Traditional cardiac risk factors are present more commonly in this group. Disclosure of Interests None declared